Theologians Explain Material and Formal Cooperation
ne of the most pressing (and most difficult to understand) issues for Catholic healthcare facilities is the issue of material cooperation. Following are frequently asked questions about this concept.
1. What is the principle of cooperation? The best answer to this question is the explanation in the appendix of the recently revised Ethical and Religious Directives for Catholic Health Care Services, unanimously approved by the National Conference of Catholic Bishops (NCCB): The principles governing cooperation differentiate the action of the wrongdoer from the action of the cooperator through two major distinctions. The first is between formal and material cooperation. If the cooperator intends the object of the wrongdoer's activity, then the cooperation is formal and, therefore, morally wrong. Since intention is not simply an explicit act of the will, formal cooperation can also be implicit. Implicit formal cooperation is attributed when, even though the cooperator denies intending the wrongdoer's object, no other explanation can distinguish the cooperator's object from the wrongdoer's object. If the c o o p e r a t o r does not i n t e n d the object of the w r o n g d o e r ' s activity, the cooperation is material and can be morally licit. The second distinction deals withthe object of the action and is expressed by immediate and mediate material cooperation. Material cooperation is immediate when the object of the cooperator is the same as the object of the w r o n g d o e r .
Immediate material cooperation is wrong, except in some instances of duress. The matter of duress distinguishes immediate material cooperation from implicit formal cooperation. But immediate material cooperation—without duress—is equivalent to implicit formal cooperation and, therefore, is morally wrong. When the object of the cooperator's action remains distinguishable from that of the w r o n g d o e r ' s , material cooperation is mediate and can be morally licit. Moral t h e o l o g i a n s r e c o m m e n d t w o other considerations for the proper evaluation of material cooperation. First, the object of material cooperation should be as distant as possible from the wrongdoer's act. Second, any act of material cooperation requires a proportionately grave reason. Prudence guides those involved in cooperation to estimate questions of intention, duress, distance, necessity and gravity. In making a judgment about cooperation, it is essential that the possibility of scandal should be eliminated. Appropriate consideration should also be given to the church's prophetic responsibility.1 2. H o w is the principle used? Until recent years the principle was used to help individuals find out how they could continue to act morally when they came into contact with others—superiors, partners, or clients—who were involved in what the Catholic tradition labels as wrongful activity. The principle was used to help individuals determine to what extent they could perform their own activity when others were acting wrongly and the activity of each intersected. Thus, in the category of superiors, there was the
BY REV. JAMES F. KEENAN, SJ, & REV. THOMAS R. KOPFENSTEINER
Fr. Keenan is assistant professor, moral theology, Weston School of Theology, Cambridge, MA, and Fr. Kopfensteiner is associate professor, moral theology, Kcnrick School of Tljeology, St. Louis.
APRIL 1995 •
servant who transported letters for his master to a w o m a n with whom he was having an affair. H o w could the subordinate continue his employment in • j i that situation? C o n cerning partners, there was the case of the spouse who practiced birth control methods against the will of the partner. What were the , c o n d i t i o n s by which the partner could engage in legitimate marital relations with the one practicing such methods? Finally,